Pneumolabyrinth after intratympanic steroid injection in patient with prosthesis of the stapes: A case report

• Published in: American journal of otolaryngology 2013-11, Vol.34 (6), p.759-761
• Main Authors: Covelli, Edoardo, MD, Attanasio, Giuseppe, MD, PhD, Cagnoni, Laura, MD, Viccaro, Marika, MD, PhD, Filipo, Roberto, MD
• Format: Article
• Language: English
• Subjects: Air; Fractures; Glucocorticoids - administration & dosage; Glucocorticoids - adverse effects; Hearing loss; Hospitals; Humans; Injections - adverse effects; Labyrinth Diseases - etiology; Labyrinth Diseases - surgery; Male; Middle Aged; Nystagmus, Pathologic - etiology; Nystagmus, Pathologic - surgery; Ossicular Prosthesis; Otolaryngology; Prostheses; Reflex, Abnormal; Stapes Surgery; Surgery; Tomography, X-Ray Computed; Tympanic Membrane; Vertigo
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2013.06.002

Abstract The aim of this study is to present a patient who developed a pneumolabyrinth following intratympanic steroid injection performed one year after stapes surgery. The patient started a medical treatment but since no improvement of his symptoms occurred, 10 days after the intratympanic injection a surgical treatment was proposed. An exploratory tympanotomy showed a displacement of the stapes prosthesis from the platinotomy, a dislocation of the incus long process, a fracture of the footplate and a depression into the vestibule. The fragment of the broken footplate was removed, a new prosthesis was located. Nausea, vertigo and nystagmus resolved immediately following surgery with a hearing threshold unchanged. In the present case report, the pathogenesis of pneumolabyrinth may be connected to an IT steroid injection proposed to the patient for the onset of sudden sensorineural hearing loss. To our knowledge, no case of a pneumolabyrinth provoked by intratympanic steroid injection has been previously described.